Deadline looms for Lingle’s list of vetoes

With several dozen bills on her desk still awaiting action, Lingle has until tomorrow to inform the Legislature which bills might get rejected.

House and Senate leaders won't predict which bills they think might be on the veto block, adding that they'll wait for the list and caucus later next week to determine which ones have enough support for an override.

Lingle has until July 10 to make a final decision on any vetoes, and lawmakers would have to convene before noon that day to override her.

Among the bills being considered by Lingle's administration is one to create five regional governing boards within Hawaii Health Systems Corp.

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Few bills in the legislative session underwent as many changes and rough drafts as Senate Bill 1792, a proposal that would establish regional boards of governance for Hawaii Health Systems Corp.

With no shortage of opinion and suggestions from all sides, the measure went through nine iterations and floor amendments in each chamber before ultimately being passed as SB 1792, Senate Draft 3, House Draft 3, Conference Draft 2.

"This one is really one of those very perplexing bills," said Linda Smith, Gov. Linda Lingle's senior policy adviser. "It's not a matter of black or white. It's clearly a matter of gray."

The administration continues to receive input on SB 1792 and other bills as Lingle approaches tomorrow's deadline to inform lawmakers which bills she may veto.

Lingle then has until July 10 to issue any vetoes. Majority Democrats, who have enough members in each chamber to override any vetoes, would have to convene that day to do so.

House and Senate leaders declined to predict which measures might get vetoed, adding that they would wait for the list before deciding whether to override any vetoes.

Democrats plan to caucus soon after Lingle releases her veto list.

Smith said last week that the Health Systems bill -- described by some as the most controversial bill of the session -- likely would be among the last vetoes decided.

The Hawaii Health Systems Corp. was established in 1996 to oversee the state's 12 rural hospitals. Kahuku Hospital was added to the system this year, bringing the total to 13.

Senate Bill 1792 establishes a new board for the health system and also sets up five regional boards with governance powers over operations and finances of hospitals in their region.

It was introduced by the Senate's Maui delegation -- Sens. Rosalyn Baker, Shan Tsutsui and J. Kalani English -- as a way to gather more input from communities and have health care decisions made at a more local level.

But while many agreed that change was needed, even those within the agency often differed on how to best accomplish that goal, causing disagreements even within the health care community.

The contentiousness over the bill prompted Smith to call a meeting to hear the various concerns from all involved.

"This is one of the bills where genuinely people are not sure what they want to advise the governor to do," Smith said. "They say, 'Well, the bill is good in this way, but not good in this way.' In other words, it's not a clear-cut decision."

The June 13 meeting convened at least two representatives from each of the health system hospitals, agency executives including President and Chief Executive Officer Tom Driskill, members of the Legislature and others.

One of the primary issues was the establishment of the new regional boards, with many concerned that it could lead to competition among regions.

"I encouraged everyone to avoid that at all costs," said House Health Chairman Josh Green (D, Keahou-Honokahou). "They really should band together when they come to the Legislature and ask for a system-wide, sensible budget, rather than pet projects."

Green, an emergency room physician, originally voted against the measure because of that concern, but has since come around to support the bill.

"I don't think they will (compete)," Green added. "I think they really recognize how important it is to work together."

Driskill said he, too, had concerns that competition could create a situation of "haves and have-nots."

"We've got to be very, very careful on that point," he said. "Before HHSC, it used to be whoever had the strongest legislators, that was the region or the hospital that would get the most support.

"We don't want it to turn into that situation because that's not the right way to allocate the work and the support."

A key to avoiding that kind of situation is careful implementation of the bill, said Wesley Lo, chief executive officer of Maui Memorial Medical Center.

"It doesn't have to lead to competition," Lo said. "That's certainly not our intent.

"If we choose for it not to be competitive and instead work collaboratively as a system, it won't be competitive."

Lo added that he, like others, felt the meeting with Smith was helpful in presenting all viewpoints on the Legislation.

Green, for one, said he does not expect the bill to be vetoed.

"I think she will let it become law," he said. "I think it's time to put our best foot forward, accept that we're going to have regional boards and make them improve the system."